[evansmom]

Remember voriconazole is hard on the liver so your father's jaundice may have been caused by that. As far as the confusion and droopy eyelid go, I'd be concerned that the fungus has become disseminated meaning it has invaded his brain (confusion) and sinus cavities (droopy eyelid). I truly hope this is not the case but these are the things that come to my mind. If this were me, I'd rather come off all immunosuppression and try another antifungal as people here have suggested. Before starting posaconazole, I think a CT guided lung biopsy is entirely appropriate. This CAN be done safely immediately post several units of platelets. I'd want to see a platelet count of 80 or higher. Remember these platelets will survive 4-5 days so invasive procedures are safe.